Elder Medical Benefits

The Elder Benefit Program reimburses tribal elders 65 years and older up to $500 per fiscal year for out-of-pocket medical expenses. Out-of-pocket medical expenses that are reimbursable under this program are those that are medically necessary, but not covered by insurance, or if no insurance coverage is present. Office visit co-pays (medical, dental, vision, chiropractic), prescription co-pays, medical equipment (such as blood-glucose monitors, blood pressure monitors, etc.),eyeglasses, hearing aids and dentures are examples of the out-of-pocket medical expenses that can be reimbursed through this program.

For customer service, call 1-800-825-3540.

Using Your Elder Benefit

This program runs on fiscal year, which begins October 1st and ends September 30th of each year.

Each participant must submit an enrollment application to receive his or her card. Each year, participants must resubmit an application to reload card.

Only actual charges are eligible for reimbursement. Please do not submit copies of checks, cancelled checks, copies of money orders, or receipts from the purchase of money orders for reimbursement under this program.

$500 is the maximum benefit allowable per tribal member, per fiscal year.

Changes to Benefit Card for 2017

HealthSmart will be changing flex processing system for 2017. HealthSmart was using two different flex claims systems in their offices across the country in 2016. We will now have the same flex claim system throughout HealthSmart. We have made this change to one system in order to have backup during those unforeseen times such as when a natural disaster occurs.

Here are the current changes for 2017 which I noted throughout the documents attached:

Due to the change in claims processing systems for 2017, new Debit Cards will need to be ordered and will be a MasterCard instead of a VISA. Your current Visa Debit Card will be terminated on 12/26/2016 regardless of the expiration date on the card. The new MasterCard will be activated on 12/30/2016 and the participants will have the remaining 2016 balances loaded on the MasterCard as of 12/30/2016 (there will not be an active Debit card for the timeframe of 12/26/16-12/29/16).

Manual Claims: Due to the change of claims processing systems, we will be unable to reimburse claims submitted via email, fax, mail or consumer portal from 12/15/2016 through 12/30/2016. You may continue to submit claims during this time via email, mail or fax and we will begin processing the claims received during the timeframe of 12/15/2016-12/30/2016 on 12/31/2016. We apologize for any inconvenience this delay may cause you and your members.

News Items

Discounts and Deals:
The Miami Nation Gift Shop offers a year round discount of 15% off Pendleton blankets and accessories or 20 % off with proof of any Native American tribal enrollment card. Shop Online